A Prospective, Multi-Center Phase I Study of Postoperative Enoxaparin Treatment in Patients Undergoing Curative Hepatobiliary-Pancreatic Surgery for Malignancies

Dig Surg. 2020;37(1):81-86. doi: 10.1159/000497451. Epub 2019 Jun 11.

Abstract

Background: Venous thromboembolism (VTE) is one of the critical complications that can occur after surgery. A positive association between cancer and VTE risk is well established; however, the safety and efficacy of VTE prophylaxis have not been established in hepatobiliary-pancreatic surgery, especially in surgery for malignancies.

Methods: A prospective, multi-center Phase I study to determine the safety of enoxaparin was performed. Subcutaneous injection of enoxaparin was initiated 48-72 h after surgery and repeated for 8 days. The primary endpoint was the incidence of bleeding events. This study was registered with the University Hospital Medical Information Network Clinical Trials Registry (UMIN000007761).

Results: A total of 154 patients was registered and 133 patients including 74 hepatectomies and 35 pancreaticoduodenectomies were analyzed. Three patients (2.3%) exhibited major bleeding events postoperatively, while 7 (5.2%) had minor bleeding. No Symptomatic VTE was observed.

Conclusions: Our study indicated that enoxaparin was well tolerated and safe for patients who received hepatobiliary-pancreatic surgery for malignancies.

Keywords: Enoxaparin; Hepatobiliary-pancreatic surgery; Malignancies; Postoperative venous thromboembolism.

Publication types

  • Clinical Trial, Phase I
  • Multicenter Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Anticoagulants / administration & dosage*
  • Biliary Tract Neoplasms / complications
  • Biliary Tract Neoplasms / surgery
  • Chemoprevention
  • Digestive System Neoplasms / complications
  • Digestive System Neoplasms / surgery*
  • Digestive System Surgical Procedures / adverse effects*
  • Enoxaparin / administration & dosage*
  • Female
  • Hepatectomy / adverse effects
  • Humans
  • Liver Neoplasms / complications
  • Liver Neoplasms / surgery
  • Male
  • Middle Aged
  • Pancreatic Neoplasms / complications
  • Pancreatic Neoplasms / surgery
  • Pancreaticoduodenectomy / adverse effects
  • Prospective Studies
  • Registries
  • Venous Thromboembolism / etiology
  • Venous Thromboembolism / prevention & control*

Substances

  • Anticoagulants
  • Enoxaparin